{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T07:01:20Z","timestamp":1780038080368,"version":"3.53.1"},"reference-count":73,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the clinical efficacy of different blood purification modes on Severe Acute Pancreatitis (SAP) based on a network meta-analysis, providing new insights for clinical treatment of SAP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Computerized searches were conducted in English databases (PubMed, Embase, Cochrane Library, Web of Science) and Chinese databases (CNKI, VIP, Wangfang Data, CBM) for clinical trials published through December 1, 2025, evaluating various blood purification modes for SAP. Study quality was assessed using the RoB 2.0 (Cochrane risk of bias tool for randomized trials, version 2). Meta-analysis was performed using STATA 18.0 software under the frequentist framework with a random-effects model. Surface Under the Cumulative Ranking Curve (SUCRA) values were used to rank the efficacy of interventions. Publication bias was assessed using funnel plots, and loop inconsistency was examined for closed loops in the evidence network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 45 randomized controlled trials involving 3,707 patients were included. The network meta-analysis showed that regarding the primary outcome of Acute Physiology and Chronic Health Evaluation (APACHE II) scores, hemoperfusion + continuous renal replacement therapy ranked as the most effective intervention. For secondary outcomes:continuous renal replacement therapy plus plasma exchange and hemoperfusion combined with continuous renal replacement therapy were among the most effective interventions for reducing amylase (AMS), C-reactive protein (CRP), interleukin-6 (IL-6). Hemoperfusion combined with continuous renal replacement therapy demonstrated the greatest improvement in triglyceride (TG) levels in patients with hyperlipidemic SAP, and in renal function (Scr). However, in terms of mortality outcomes, blood purification did not show a trend toward benefit compared with conventional therapy. And for certain outcomes, loop inconsistency was detected and heterogeneity could not be effectively resolved, warranting cautious interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hemoperfusion combined with continuous renal replacement therapy demonstrateds more satisfactory therapeutic effects and significantly reduces amylase levels, improves inflammatory response, renal function, and disease severity in SAP patients, and effectively lowers TG levels in those with hyperlipidemic SAP, but hemoperfusion combined with continuous renal replacement therapy does not significantly decrease mortality. These findings provide evidence-based guidance for clinical decision-making, though further high-quality trials are required to confirm the optimal blood purification strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:ext-link>\n                      , identifier CRD420261403366.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1767153","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T06:00:57Z","timestamp":1780034457000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy of different blood purification modes on severe acute pancreatitis: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Peihong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Emergency, Dongfang Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Emergency, Dongfang Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Dongfang Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolei","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Emergency, Dongfang Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"739","DOI":"10.19538\/j.cjps.issn1005-2208.2021.07.03","article-title":"Chinese guidelines for the diagnosis and treatment of acute pancreatitis (2021).","volume":"41","author":"Li","year":"2021","journal-title":"Chin J Pract Surg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"5043","DOI":"10.3748\/wjg.v13.i38.5043","article-title":"Severe acute pancreatitis: clinical course and management.","volume":"13","author":"Beger","year":"2007","journal-title":"World J Gastroenterol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"118","DOI":"10.20452\/pamw.1627","article-title":"2012 revision of the Atlanta classification of acute pancreatitis.","volume":"123","author":"Sarr","year":"2013","journal-title":"Pol Arch Med Wewn"},{"key":"B4","first-page":"1114","article-title":"Guidelines for the Integrated Chinese and western medicine diagnosis and treatment of severe acute pancreatitis.","volume":"40","author":"Cui","year":"2024","journal-title":"J Clin Hepatol Biliary Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1136\/gutjnl-2012-302779","article-title":"Classification of acute pancreatitis\u20132012: revision of the Atlanta classification and definitions by international consensus.","volume":"62","author":"Banks","year":"2013","journal-title":"Gut"},{"key":"B6","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1016\/j.pan.2020.03.018","article-title":"Hypertriglyceridemia-induced acute pancreatitis: a prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases.","volume":"20","author":"Mosztbacher","year":"2020","journal-title":"Pancreatology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"441","DOI":"10.3760\/cma.j.issn.1673-4181.2019.05.015","article-title":"Mechanisms and research advances in blood perfusion therapy for endotoxemia.","volume":"42","author":"Li","year":"2019","journal-title":"Int J Biomed Eng."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1159\/000547477","article-title":"Current knowledge on the impact of extracorporeal blood purification devices on drug clearance - systematic search &amp.","volume":"54","author":"Paul","year":"2025","journal-title":"Narrat Rev. 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